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General NPI Number Information
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NPI Number | 1760932693
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Entity Type | Individual
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Provider Name | SHANNON LANDRY PHARMD
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Gender | Female
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Dates
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Enumeration Date | 10/04/2016
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Last Update Date | 05/02/2022
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Provider Practice Location Address
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Address Line | 2601 GENE GEORGE BLVD PHARMACY DEPARTMENT
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City | SPRINGDALE
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State | AR
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Zip | 72704
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Country | US
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Telephone | 479-725-6842
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Fax |
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Provider Business Mailing Address
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Address Line | 2601 GENE GEORGE BLVD PHARMACY DEPARTMENT
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City | SPRINGDALE
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State | AR
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Zip | 72704
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Country | US
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Telephone | 479-725-6842
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS55652
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PD16031
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License Number State | AR
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